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<table border="0" cellpadding="2" cellspacing="2" style="width: 100%;">
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			<td style="text-align: justify; width: 10%; vertical-align: bottom;">{% select_tag name=&quot;e186034e&quot; data_label=&quot;civilit&eacute;&quot; data_map_field=&quot;nomap&quot; data_choices=&quot;Choix|;Monsieur|Mr; Madame|Ms; Monsieur et Madame|Mr and Ms; Madame et madame|Ms and Ms; Monsieur et Monsieur|Mr and Mr; La soci&eacute;t&eacute;|The company;&quot; data_required_field=&quot;true&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="text-align: justify;">{% textinput_tag name=&quot;7ee96610&quot; data_label=&quot;Nom et pr&eacute;nom de l&#39;offreur&quot; data_map_field=&quot;nomap&quot; maxlength=&quot;70&quot; data_required_field=&quot;true&quot; data_bold_text=&quot;false&quot; %}</td>
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			<td colspan="2"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">se propose d&rsquo;acqu&eacute;rir le dit bien moyennant le prix de en euros (en lettres et en chiffres)</span></td>
		</tr>
		<tr>
			<td colspan="2">{% textarea_tag name=&quot;b39ba32b&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Prix du bien&nbsp;(en chiffres et en lettres, FR)&quot; data_map_field=&quot;sell_price&quot; data_help=&quot;Prix &quot; data_required_field=&quot;true&quot; data_bold_text=&quot;false&quot; %}</td>
		</tr>
	</tbody>
</table>

<table border="0" cellpadding="2" cellspacing="2" style="width:100%;">
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			<td style="width: 20%; vertical-align: bottom;">{% select_tag name=&quot;f0f0f25f&quot; data_label=&quot;le prix comprend ou pas les honoraires&quot; data_map_field=&quot;nomap&quot; data_choices=&quot;choix|; comprenant|comprenant; ne comprenant pas|ne comprenant pas;&quot; data_required_field=&quot;true&quot; data_bold_text=&quot;false&quot; %}</td>
			<td colspan="2" rowspan="1" style="vertical-align: bottom;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">les honoraires de n&eacute;gociation s&rsquo;&eacute;levant en euros &agrave; :</span></td>
		</tr>
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			<td colspan="3">{% textarea_tag name=&quot;618c65da&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Montant des honoraires de n&eacute;gociation FR&quot; data_help=&quot;Montant des honoraires de n&eacute;gociation&quot; data_required_field=&quot;true&quot; data_bold_text=&quot;false&quot; %}</td>
		</tr>
	</tbody>
</table>

<table border="0" cellpadding="2" cellspacing="2" style="width:100%;">
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			<td style="width: 10%; vertical-align: bottom;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">&agrave; la charge</span></td>
			<td style="vertical-align: bottom;">{% select_tag name=&quot;aa3a5aef&quot; data_label=&quot;Les honoraires sont &agrave; la charge de&quot; data_map_field=&quot;nomap&quot; data_choices=&quot;choix|; du vendeur|du vendeur; de l&#39;acqu&eacute;reur|de l&#39;acqu&eacute;reur;&quot; data_required_field=&quot;true&quot; data_bold_text=&quot;false&quot; %}</td>
			<td>&nbsp;</td>
		</tr>
	</tbody>
</table>

<table border="0" cellpadding="2" cellspacing="2" style="width:100%;">
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			<td style="text-align: justify; width: 10%; vertical-align: bottom;">{% select_tag name=&quot;e186034e&quot; data_label=&quot;civilit&eacute;&quot; data_map_field=&quot;nomap&quot; data_choices=&quot;Mr|Mr; Ms|Ms; Mr and Ms|Mr and Ms; Ms and Ms|Ms and Ms; Mr and Mr|Mr and Mr; The company|The company;&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="text-align: justify;">{% textinput_tag name=&quot;7ee96610&quot; data_label=&quot;Name&quot; data_map_field=&quot;nomap&quot; maxlength=&quot;70&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
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			<td colspan="2"><span style="font-weight:600;"><span style="font-family: ITCAvantGardePro; font-size: 12px;">offers to buy the aforementioned property in euro for (indicate the price in letters and numbers)</span></span></td>
		</tr>
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			<td colspan="2">{% textarea_tag name=&quot;f820f946&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Price&quot; data_map_field=&quot;sell_price&quot; data_help=&quot;Prix &quot; data_required_field=&quot;true&quot; data_bold_text=&quot;false&quot; %}</td>
		</tr>
	</tbody>
</table>

<table border="0" cellpadding="2" cellspacing="2" style="width:100%;">
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		<tr>
			<td style="width: 20%; vertical-align: bottom;">{% select_tag name=&quot;f0f0f25f&quot; data_label=&quot;comrpising or not comprising&quot; data_map_field=&quot;nomap&quot; data_choices=&quot;choix|; comprising|comprenant; not comprising|ne comprenant pas;&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td colspan="2" rowspan="1" style="vertical-align: bottom;"><span style="font-weight:600;"><span style="font-family: ITCAvantGardePro; font-size: 12px;">agency fees in euros of </span></span>&nbsp;:</td>
		</tr>
		<tr>
			<td colspan="3">{% textarea_tag name=&quot;2d98a418&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Agency fees&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Montant des honoraires de n&eacute;gociation&quot; data_required_field=&quot;true&quot; data_bold_text=&quot;false&quot; %}</td>
		</tr>
	</tbody>
</table>

<table border="0" cellpadding="2" cellspacing="2" style="width:100%;">
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			<td style="width: 10%; vertical-align: bottom;"><span style="font-weight:600;"><span style="font-family: ITCAvantGardePro; font-size: 12px;">paid by</span></span></td>
			<td style="vertical-align: bottom;">{% select_tag name=&quot;aa3a5aef&quot; data_label=&quot;Borne by&quot; data_map_field=&quot;nomap&quot; data_choices=&quot;choice|; the seller|du vendeur; the buyer|de l&#39;acqu&eacute;reur;&quot; data_required_field=&quot;true&quot; data_bold_text=&quot;false&quot; %}</td>
			<td>&nbsp;</td>
		</tr>
	</tbody>
</table>

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